Abstract
Research question
What is the association of the entire range of trigger-day endometrial thickness (EMT)
with live birth rate (LBR) after IVF and fresh embryo transfer? Although EMT is amenable
to convenient non-invasive routine measurement, studies of the association between
pre-trigger EMT and assisted reproductive technology outcome have yielded equivocal
results.
Design
A cohort of IVF fresh day-3 embryo transfers in patients aged 42 years and younger
in a single centre between 2009 and 2017. The LBR was calculated for all trigger-day
EMT values, stratified into five groups overall and within subgroups of patient age
and ovarian response. Univariate analysis and multivariate logistic regression models
were used to compare the LBRs at different EMT measurements adjusting for various
independent variables.
Results
A total of 5133 cycles were included. The LBRs were as follows: 11.22% (35/312) in
cycles with EMT 6 mm or less, 17.98% (380/2114) in cycles with EMT 7–9 mm, 23.44%
(476/2031) in cycles with EMT 10–12 mm, 25.62% (144/562) in cycles with EMT 13–15
mm and 34.21% (39/114) in cycles with EMT 16 mm or more (P < 0.001). Similar findings were observed by patient age and ovarian response. The
observation was confirmed by multivariate logistic regression analysis in which the
EMT was found to be a significant independent predictor of LBR even after controlling
for various confounders (OR 0.935, 95% CI 0.908 to 0.962; P < 0.001).
Conclusions
Pre-trigger EMT is in significant independent correlation with LBR, even after adjusting
for age and ovarian response. Maximal endometrial proliferation is beneficial, and
fresh embryo transfer can be carried out at high EMT values without endangering the
outcome of the cycle.
KEYWORDS
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Biography
Yoel Shufaro MD, PhD, is the head of the Beilinson Infertility and IVF unit, and Senior Lecturer at the Felsenstein Medical Research Center, Faculty of Medicine, Tel-Aviv University. His clinical research focuses on optimizing ART and its feto–maternal outcome. His current basic research is focused on the field of fertility preservation and restoration.
Article info
Publication history
Published online: May 12, 2020
Accepted:
April 8,
2020
Received in revised form:
April 7,
2020
Received:
February 11,
2020
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2020 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
